Cost and quality performance indicators for home community-based care services to orphans and vulnerable children
South African Journal of Economics
Health Economics Research Office, Bopaki Health Systems Consulting; National Department of Health, Partnership for the Delivery of Primary Health Care Programme (PDPHCP), AEDES, Brussels, Belgium; National Department of Social Development, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa; National Department of Health, PDPHCP, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa; School of Economics and Finance, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa
The encouragement of care of orphans and vulnerable children by non-profit organisations (NPOs) is a major policy response to the HIV and AIDS epidemic in South Africa. The purpose of this article is to present a quality-cost model with five performance indicators for quality and two for costs and to test these against actual performance using data collected from nine rural and urban organisations in 2004 and 2005. Six NPOs had acceptable cost but all had unacceptable quality scores; three had unacceptable cost and unacceptable quality scores. Each rural caregiver had many more orphans and vulnerable children beneficiaries than their urban counterparts but made fewer total visits. As a result, urban beneficiaries received, on average, 3.5 times more visits than their rural counterparts. The results suggest the need for different performance indicators and expectations for rural and urban NPOs and that monitoring and evaluation using the model could improve horne community-based care services. © 2008 The Author. Journal compilation © 2008 The Economic Society of South Africa.
acquired immune deficiency syndrome; child care; epidemic; health care; health services; human immunodeficiency virus; Africa; South Africa; Southern Africa; Sub-Saharan Africa